POS1530 FACTORS ASSOCIATED WITH THE RETENTION OF SECUKINUMAB (SEC) IN PATIENTS WITH PSORIATIC ARTHRITIS (PSA) IN REAL WORLD PRACTICE: RESULTS FROM THE RETROSPECTIVE FORSYA STUDY
Authors: A. Ruyssen-Witrand, A. Lardy-Cléaud, E. Desfleurs, P. Claudepierre, M. Dougados, P. Goupille, C. Lukas, A. Saraux, A. Tournadre, D. Wendling
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> While data on real-life retention of SEC in patients (pts) with PsA is accumulating, there are few data on predictive factors of this retention. <h3>Objectives</h3> To assess if objective signs of inflammation (OSI) were predictive of SEC retention at 1 year. <h3>Methods</h3> French retrospective study collecting between Oct 2019 and May 2022 data from PsA pts a) having initiated and received at least one dose of SEC between Aug 2016 and Aug 2018 (cohort 1) and Sept 2018 and Nov 2020 (cohort 2) (b) with at least a 1 year follow-up period. Retention rate of SEC at 1 year was estimated by the Kaplan Meier (KM) method. OSI were defined by at least one of the following within the 3 months before initiation of SEC: CRP&gt; N, confirmed clinical dactylitis, confirmed clinical synovitis or ultrasonography power-Doppler positive synovitis. The following a priori baseline preselected factors of SEC retention at 1 year (cohort, ≥1 OSI, age, sex, BMI, smoking, axial feature, history of arthritis or synovitis/ psoriasis/ uveitis/ IBD, diagnostic delay, disease duration, SEC line (L) of biologic/targeted synthetic (b/ts)DMARD, SEC dose, csDMARD/ corticosteroids at initiation, history of fibromyalgia/ depression) were analyzed by cox model regression. Only variables with &lt;20% missing data were included in the model after multiple imputation and stepwise selection (significance level for entering variables = 20%; for removing variables = 10%). OSI and cohort variables were forced into the model whatever their significance level or rate of missing data. <h3>Results</h3> 842 pts (male: 38.6%, mean age: 52.5 ± 12.3 years, mean disease duration: 8.7 ± 8.5 years) from 50 centers were included in the analysis. At initiation of SEC, 63.0% of pts had ≥ 1 OSI and respectively 15.8%, 24.2% and 60.0% were in 1<sup>st</sup>, 2<sup>nd</sup> and ≥ 3<sup>rd</sup> (L) of b/ts DMARD. The 1 year retention rate for SEC was 64% [95%CI: 61%-68%] and was numerically greater in 1<sup>st</sup> L vs 2<sup>nd</sup> and ≥3<sup>rd</sup> L (77% [69%-84%], 65% [59-72%], 61% [57%-66%] respectively). The 1 year retention rates of SEC were 65% [61%-69%] and 69% [62%-75%] respectively for OSI+ and OSI- at SEC initiation. In multivariate analysis after adjustment, OSI was not identified as predictive of SEC discontinuation at 1 year (HR=1.19 |0.93;1.52], p=0.169). The others predictive factors identified are listed in Table 1. <h3>Conclusion</h3> In this large cohort of PsA patients, the overall retention rate of SEC was 64% at 1 year in daily practice. Previous exposure to b/tsDMARD, concomitant corticosteroids at initiation of SEC and history of fibromyalgia were associated with an increased risk of SEC discontinuation at 1 year while concomitant csDMARD at initiation of SEC and age &gt; 40 year with a decreased risk. <h3>Acknowledgements</h3> Authors thank all participating investigators, centers and patients. This study was financially supported by NOVARTIS Pharma France. <h3>Disclosure of Interests</h3> Adeline Ruyssen-Witrand Speakers bureau: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Fresenius-Kabi, Galapagos, Janssen, Lilly, MSD, Mylan, Nordic-Pharma, Novartis, Pfizer, Roche Chugai, Sanofi, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Mylan, Novartis, Pfizer Inc, Sanofi Genzyme, Grant/research support from: AbbVie, Amgen, Mylan, Pfizer Inc, Audrey Lardy-Cléaud: None declared, Emilie Desfleurs Employee of: Novartis employee, Pascal Claudepierre Speakers bureau: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Consultant of: Abbvie, Pfizer, Roche-Chugai, Bristol-Myers Squibb, MSD, UCB, Novartis, Janssen, Lilly, Celgene, Maxime Dougados Speakers bureau: Pfizer, Abbvie, Lilly, UCB, Merck, BMS, Roche, Biogen, Sanofi, Novartis, and Sandoz, Consultant of: Pfizer, Abbvie, Lilly, UCB, Merck, BMS, Roche, Biogen, Sanofi, Novartis, and Sandoz, Grant/research support from: Pfizer, Abbvie, Lilly, UCB, Merck, BMS, Roche, Biogen, Sanofi, Novartis, and Sandoz, Philippe Goupille Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Grant/research support from: Abbvie, Biogen, MSD, Pfizer, Cédric Lukas Speakers bureau: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai, UCB, Consultant of: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai, UCB, Grant/research support from: Pfizer, Novartis and Roche-Chugai, Alain Saraux Speakers bureau: Abbvie, Biogen, Bristol Myers Squibb, Fresenius, Galapagos, GSK, Lilly, Merck Sharp, Nordic, Novartis, Pfizer, Roche-Chugai, UCB, Consultant of: Abbvie, Lilly, Novartis, Pfizer, Grant/research support from: Roche-Chugai, Lilly, Fresenius, Anne Tournadre Speakers bureau: Abbvie, Fresenius, Janssen, MSD, Pfizer, Roche Chugai, Sanofi, Paid instructor for: Fresenius, Consultant of: Abbvie, Fresenius, Lilly, Novartis, Sanofi, Grant/research support from: Fresenius, Novartis, Pfizer, UCB, Daniel Wendling Speakers bureau: AbbVie, BMS, MSD, Pfizer, Roche Chugai, Amgen, Nordic Pharma, UCB, Novartis, Lilly, Sandoz, Grunenthal, Janssen, Galapagos, Consultant of: Novartis.